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淋巴瘤和多发性骨髓瘤的 PET/CT 成像概述及最新进展。

Overview and recent advances in PET/CT imaging in lymphoma and multiple myeloma.

机构信息

IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Nuclear Medicine, via Massarenti 9, 40138, Bologna, Italy.

Nuclear Medicine, DIMES, Alma Mater studiorum, Università di Bologna, Bologna, Italy.

出版信息

Eur J Radiol. 2021 Aug;141:109793. doi: 10.1016/j.ejrad.2021.109793. Epub 2021 May 27.

Abstract

Imaging in hematological diseases has evolved extensively over the past several decades. Positron emission tomography/computed tomography (PET/CT) with of 2-[18 F]-fluoro-2-deoxy-d-glucose ([18 F] FDG) is currently essential for accurate staging and for early and late therapy response assessment for all FDG-avid lymphoproliferative histologies. The widely adopted visual Deauville 5-point scale and Lugano Classification recommendations have recently standardized PET scans interpretation and improved lymphoma patient management. In addition [18 F] FDG-PET is routinely recommended for initial evaluation and treatment response assessment of Multiple Myeloma (MM) with significant contribution in risk-stratification and prognostication, although magnetic resonance imaging remains the Gold Standard for the assessment of bone marrow involvement. In this review, an overview of the role of [18 F] FDG-PET, in hematological malignancies is provided, particularly focusing on Hodgkin lymphoma (HL) and Diffuse Large B Cell Lymphoma (DLBCL), both in adult and pediatric populations, and MM, at each point of patient management. Potential alternative molecular imaging applications in this field, such as non-[18 F] FDG-tracers, whole body magnetic resonance imaging (WB-MRI), hybrid PET/MRI and emerging radiomics research are briefly presented.

摘要

在过去的几十年中,血液疾病的影像学有了广泛的发展。正电子发射断层扫描/计算机断层扫描(PET/CT)与 2-[18 F]-氟-2-脱氧-d-葡萄糖([18 F] FDG)的结合,对于所有 FDG 阳性的淋巴增生组织学的准确分期以及早期和晚期治疗反应评估是必不可少的。广泛采用的视觉 Deauville 5 分制和 Lugano 分类建议最近已经标准化了 PET 扫描的解释,并改善了淋巴瘤患者的管理。此外,[18 F] FDG-PET 还被常规推荐用于多发性骨髓瘤(MM)的初始评估和治疗反应评估,在风险分层和预后方面有重要贡献,尽管磁共振成像(MRI)仍然是骨髓受累评估的金标准。在这篇综述中,我们提供了 [18 F] FDG-PET 在血液恶性肿瘤中的作用概述,特别是重点关注霍奇金淋巴瘤(HL)和弥漫性大 B 细胞淋巴瘤(DLBCL),包括成人和儿童患者,以及 MM 在患者管理的各个阶段。本文还简要介绍了该领域中潜在的替代分子成像应用,如非-[18 F] FDG 示踪剂、全身磁共振成像(WB-MRI)、PET/MRI 融合和新兴的放射组学研究。

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